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The Use of Glucocorticoids in Lupus Nephritis: New Pathways for an Old Drug
Glucocorticoids therapy has greatly improved the outcome of lupus nephritis patients. Since their discovery, their adverse effects have counterbalanced their beneficial anti-inflammatory effects. Glucocorticoids exert their effects through both genomic and non-genomic pathways. Differential activati...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2021
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7921306/ https://www.ncbi.nlm.nih.gov/pubmed/33665199 http://dx.doi.org/10.3389/fmed.2021.622225 |
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author | Mejía-Vilet, Juan M. Ayoub, Isabelle |
author_facet | Mejía-Vilet, Juan M. Ayoub, Isabelle |
author_sort | Mejía-Vilet, Juan M. |
collection | PubMed |
description | Glucocorticoids therapy has greatly improved the outcome of lupus nephritis patients. Since their discovery, their adverse effects have counterbalanced their beneficial anti-inflammatory effects. Glucocorticoids exert their effects through both genomic and non-genomic pathways. Differential activation of these pathways is clinically relevant in terms of benefit and adverse effects. Ongoing aims in lupus nephritis treatment development focus on a better use of glucocorticoids combined with immunosuppressant drugs and biologics. Newer regimens aim to decrease the peak glucocorticoid dose, allow a rapid glucocorticoid tapering, and intend to control disease activity with a lower cumulative glucocorticoid exposure. In this review we discuss the mechanisms, adverse effects and recent strategies to limit glucocorticoid exposure without compromising treatment efficacy. |
format | Online Article Text |
id | pubmed-7921306 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-79213062021-03-03 The Use of Glucocorticoids in Lupus Nephritis: New Pathways for an Old Drug Mejía-Vilet, Juan M. Ayoub, Isabelle Front Med (Lausanne) Medicine Glucocorticoids therapy has greatly improved the outcome of lupus nephritis patients. Since their discovery, their adverse effects have counterbalanced their beneficial anti-inflammatory effects. Glucocorticoids exert their effects through both genomic and non-genomic pathways. Differential activation of these pathways is clinically relevant in terms of benefit and adverse effects. Ongoing aims in lupus nephritis treatment development focus on a better use of glucocorticoids combined with immunosuppressant drugs and biologics. Newer regimens aim to decrease the peak glucocorticoid dose, allow a rapid glucocorticoid tapering, and intend to control disease activity with a lower cumulative glucocorticoid exposure. In this review we discuss the mechanisms, adverse effects and recent strategies to limit glucocorticoid exposure without compromising treatment efficacy. Frontiers Media S.A. 2021-02-16 /pmc/articles/PMC7921306/ /pubmed/33665199 http://dx.doi.org/10.3389/fmed.2021.622225 Text en Copyright © 2021 Mejía-Vilet and Ayoub. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Medicine Mejía-Vilet, Juan M. Ayoub, Isabelle The Use of Glucocorticoids in Lupus Nephritis: New Pathways for an Old Drug |
title | The Use of Glucocorticoids in Lupus Nephritis: New Pathways for an Old Drug |
title_full | The Use of Glucocorticoids in Lupus Nephritis: New Pathways for an Old Drug |
title_fullStr | The Use of Glucocorticoids in Lupus Nephritis: New Pathways for an Old Drug |
title_full_unstemmed | The Use of Glucocorticoids in Lupus Nephritis: New Pathways for an Old Drug |
title_short | The Use of Glucocorticoids in Lupus Nephritis: New Pathways for an Old Drug |
title_sort | use of glucocorticoids in lupus nephritis: new pathways for an old drug |
topic | Medicine |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7921306/ https://www.ncbi.nlm.nih.gov/pubmed/33665199 http://dx.doi.org/10.3389/fmed.2021.622225 |
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